Substantial research is currently being carried out to develop selective inhibitors of cyclooxygenase-2, i.e., agents which selectively inhibit cyclooxygenase-2 in preference to cyclooxygenase-1, so as to obtain the anti-inflammatory effect of cyclooxygenase-2 inhibition without the gastrointestinal side effects, e.g., peptic ulcer disease, that occur when cyclooxygenase-1 is also inhibited. Commonly used nonsteroidal anti-inflammatory drugs inhibit both cyclooxygenase-2 and cyclooxygenase-1, and the aforementioned side effects detract from their usefulness.
The focus of the research has been on synthesis of new compounds providing selective inhibition of cyclooxygenase-2 for use for treating certain inflammatory conditions, especially arthritis. The focus has not been on developing new methods of treatment, i.e., on treating conditions not heretofore considered as appropriately treatable with cyclooxygenase-2 inhibitors. The focus has not been on developing compounds with desirable functions in addition to enzyme inhibition.
Heretofore, it was considered that cyclooxygenase inhibitors could cause liver injury and for that reason liver disease was not considered as one of the conditions that was treatable by selective inhibitors of cyclooxygenase-2.